Background: Epigenetic mechanisms alter gene expression and regulate vital cellular
processes that contribute to the onset and progression of major dental diseases. Their reversible character
may prove beneficial for therapeutic targeting. This review aims to provide an update on the
main epigenetic changes that contribute to the pathogenesis of Oral Squamous Cell Carcinoma
(OSCC), pulpitis and periodontitis as well as dental caries and congenital orofacial malformations, in
an effort to identify potential therapeutic targets.
Methods: We undertook a structured search of bibliographic databases (PubMed and MEDLINE) for
peer-reviewed epigenetic research studies focused on oral diseases in the last ten years. A qualitative
content analysis was performed in screened papers and a critical discussion of main findings is provided.
Results: Several epigenetic modifications have been associated with OSCC pathogenesis, including
promoter methylation of genes involved in DNA repair, cell cycle regulation and proliferation leading
to malignant transformation. Additionally, epigenetic inactivation of tumor suppressor genes, overexpression
of histone chaperones and several microRNAs are implicated in OSCC aggressiveness.
Changes in the methylation patterns of IFN-γ and trimethylation of histone Η3Κ27 have been detected
in pulpitis, along with an aberrant expression of several microRNAs, mainly affecting cytokine production.
Chronic periodontal disease has been associated with modifications in the methylation patterns
of Toll-Like Receptor 2, Prostaglandin synthase 2, E-cadherin and some inflammatory cytokines,
along with the overexpression of miR-146a and miR155. Furthermore, DNA methylation was
found to regulate amelogenesis and has been implicated in the pathogenesis of dental caries as well as
in several congenital orofacial malformations.
Conclusion: Strong evidence indicates that epigenetic changes participate in the pathogenesis of oral
diseases and epigenetic targeting may be considered as a complementary therapeutic scheme to the
current management of oral health.